Alcohol and Depression

Alcohol and depression have a strong relationship, although we don't
quite understand it. Research is confusing and defining depression and
alcoholism are both challenging tasks. Does alcoholism cause depression?
Does depression cause alcoholism? What about alcohol use to manage
stress and depression, can it be a good thing?

Alcoholism and major depressive disorder. What we know.

There have been many attempts to explain away the correlation between
depression and alcoholism by suggesting that depression in individuals
with alcoholism directly results from alcohol intoxication, and/or
alcohol withdrawal. For some people this is true. It is also safe tthat
some experience depression along with their alcohol use in this
context, but not as a separate diagnosis. To eliminate some confusion
the DSM suggests that you can have major depressive disorder if you were
diagnosed prior to your alcohol addiction, or four weeks after you have
stopped having withdrawal symptoms.(Hassin 2002). Still even with
clearer criteria all social science research is challenging. If you are
an alcoholic, and have real major depression, not major depression due
to your withdrawal, use or detoxification, what do we know about you and
how to help you?

Unfortunately, we still understand little about how to help.

Does alcoholism cause depression?

Some
have suggested that heavy alcohol use can actually cause major
depression. We don't know if this is or isn't the case. It does seem
that alcoholism might cause risk factors for depression to be higher.
For example if you are an alcoholic you will likely have family and
marital strain or job loss . Then, clearly you are at risk for
depression.

Once again, Studies are mixed and confusing in
determining causality. It's most likely that each individual with
alcohol and depression issues presents with a separate situation, which
makes treatment protocols less precise and individual assessment for
clinicians more important.

It's different for women than it is for men

We
do know that the relationship between alcohol and depression is
different for women than it is for men. Firstly the relationship between
alcohol and depression is stronger in women than it is in men( more
likely to occur together). Some research suggests that for women it is
more likely that the depression comes first and is later followed by
alcoholism. For men, this is the opposite.(Dixit 2000).

Does depression come before alcoholism?

I
have certainly observed in my female clients that depression often
seems to come first. In seeking to self medicate and avoid the pain they
are experiencing, they will drink, and often this will start a negative
cycle. So often, women who are depressed also have body image issues,
are taking antidepressants and battling weight gain. Alcohol often
causes them to over eat or consume more calories than they would like,
leading to regret, depression, and reinforcing the cycle. Alcohol also
wreaks havoc on blood sugar levels, appetite, and sleep, all causing a
sense of disequilibrium that may make depression more likely.

Alcohol and depression: Is alcohol good for depression?

To
further complicate things, some population based studies suggest that
moderate alcohol( 1 to 2 drinks a day) use may lower depression and
anxiety and improve overall positive feelings and emotional health.
However these studies compare moderate drinking with heavy drinking
concluding moderate drinkers have less anxiety and depression than heavy
drinkers. When compared with those who abstain some show moderate
drinkers have lower levels of depression and anxiety and some do not.
How can this be??

It seems possible that if you are a light or
moderate drinking, you are drinking socially and not to self medicate. I
think this is a different situation entirely. A pattern of avoiding
problems and feelings by drinking alcohol will reinforce depression. A
pattern of light social drinking may not. However, I don’t know many
people, or clients who fit this profile.

Alcohol and Depression and you: What can you do?

If
you are wondering about your own relationship with alcohol and
depression you may need to pay careful attention to when and why you
are drinking and how you feel before after and during drinking. If you
feel depressed the day after you drink, and find that meeting your goals
and /or responsibilities is difficult you may consider cutting down.

If
you notice you are drinking specifically to deal with depression, again
you may need to rexamine whether this is the best way for you to cope
with your negative thoughts and feelings.

The relationship between
alcohol and depression is a complex one. It varies among men and women,
different levels of drinking ( moderate, heavy and light) and different
diagnoses.

Please refer to this journal chart to help you
determine if you may have an issue with alcohol and depression. If you
find that there are many concerning areas identified, you may need to
work on your drinking patterns